Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.234
Filtrar
2.
Sports Health ; 12(3): 304-309, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32163722

RESUMO

BACKGROUND: Chronic exertional compartment syndrome (CECS) is primarily seen in running athletes. Previous outcomes of surgical treatment with fasciotomy have suggested moderate pain relief, but evidence is lacking regarding postoperative return to running. HYPOTHESIS: Running athletes with limiting symptoms of CECS will show high rates of return to running after fasciotomy. STUDY DESIGN: Case series. LEVEL OF EVIDENCE: Level 4. METHODS: Running athletes treated with fasciotomy for CECS at a single institution were identified using a surgical database and asked to complete a questionnaire designed to assess postoperative pain, activity level, return to running, running distances, overall satisfaction, and rate of revision fasciotomy. RESULTS: A total of 43 runners met the inclusion criteria, and 32 runners completed outcomes questionnaires at a mean postoperative follow-up of 66 months. In total, 27 of these 32 patients (84%) returned to sport(s) after fasciotomy. However, 9 (28%) of these patients pursued nonrunning sports, 5 (16%) due to recurrent pain with running. Of the 18 patients who returned to running sports (56%), the mean weekly running distance decreased postoperatively. Recurrence of symptoms was reported in 6 patients (19%), 4 of whom had returned to running and 2 of whom had been unable to return to sports. All of these 6 patients elected to undergo revision fasciotomy surgery. Twenty-five (78.1%) patients reported being satisfied with their procedure. In the overall cohort, the mean visual analog scale scores for pain during activities/sports decreased from 7.9 preoperatively to 1.7 postoperatively. CONCLUSION: Fasciotomy for CECS in runners may provide significant improvement in pain and satisfaction in over three-quarters of patients and return to sports in 84% of patients. However, only 56% returned to competitive running activity, with a subset (19%) developing recurrent symptoms resulting in revision surgery. CLINICAL RELEVANCE: Fasciotomy has been shown to decrease pain in most patients with CECS. This study provides outcomes in running athletes after fasciotomy for CECS with regard to return to sports, maintenance of sports performance, and rates of revision surgery.


Assuntos
Síndromes Compartimentais/cirurgia , Fasciotomia , Corrida/lesões , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Dor Pós-Operatória , Satisfação do Paciente , Reoperação , Volta ao Esporte , Resultado do Tratamento , Adulto Jovem
3.
Arthroscopy ; 36(2): 450-452, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32014176

RESUMO

Femoroacetabular impingement syndrome (FAIS) is a common cause of hip pain and dysfunction in athletes, which can impair their ability to perform and compete in sports. Hip arthroscopy has become a popular and successful treatment option for the management of FAIS and the return to sport (RTS) of athletes. The concept of RTS has evolved in the last years. Various different factors need to be considered when evaluating RTS after hip arthroscopy for FAIS, such as (1) the definition of RTS (return to participation, RTS, return to performance), (2) the sport type (high-impact vs low-impact) and sport level (professional vs recreational), and (3) the time to follow-up evaluation. In addition, return to high-impact sports, such as soccer, might not be the best recommendation for some patients undergoing hip arthroscopy for FAIS, as it may accelerate the degeneration of the hip joint. Future research should consider all these aspects of the RTS outcome after hip arthroscopy for FAIS. Valid RTS rates are of utmost importance to provide adequate expectations to patients and to guide decision-making of hip surgeons.


Assuntos
Impacto Femoroacetabular , Futebol , Artroscopia , Atletas , Seguimentos , Articulação do Quadril , Humanos , Volta ao Esporte
4.
Arthroscopy ; 36(2): 479-480, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32014178

RESUMO

Hip arthroscopy has proved its efficacy and value in the management of femoroacetabular impingement syndrome in recreational and professional athletes. However, needs, expectations, and economic burden are remarkable and astonishingly different within the elite sport world. When considering hip arthroscopy to address a femoroacetabular impingement condition, 3 big questions are asked by every athlete and must be answered: (1) Can I play again? (2) Will I play at the same level? (3) When can I return to sport? Regarding the National Basketball Association, approximately 88% of athletes return to play at the same level in about 6 months.


Assuntos
Basquetebol , Impacto Femoroacetabular , Artroscopia , Atletas , Articulação do Quadril , Humanos , Volta ao Esporte
6.
Sports Health ; 12(2): 124-131, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31916920

RESUMO

CONTEXT: Recent studies examining return to sport after traumatic shoulder instability suggest faster return-to-sport time lines after bony stabilization when compared with soft tissue stabilization. The purpose of the current study was to define variability across online Latarjet rehabilitation protocols and to compare Latarjet with Bankart repair rehabilitation time lines. EVIDENCE ACQUISITION: Online searches were utilized to identify publicly available rehabilitation protocols from Accreditation Council for Graduate Medical Education (ACGME)-accredited academic orthopaedic surgery programs. STUDY DESIGN: Descriptive epidemiology study. LEVEL OF EVIDENCE: Level 3. RESULTS: Of the 183 ACGME-accredited orthopaedic programs reviewed, 14 institutions (7.65%) had publicly available rehabilitation protocols. A web-based search yielded 17 additional protocols from private sports medicine practices. Of the 31 protocols included, 31 (100%) recommended postoperative sling use and 26 (84%) recommended elbow, wrist, and hand range of motion exercises. Full passive forward flexion goals averaged 3.22 ± 2.38 weeks postoperatively, active range of motion began on average at 5.22 ± 1.28 weeks, and normal scapulothoracic motion by 9.26 ± 4.8 weeks postoperatively. Twenty (65%) protocols provided specific recommendations for return to nonoverhead sport-specific activities, beginning at an average of 17 ± 2.8 weeks postoperatively. This was compared with overhead sports or throwing activities, for which 18 (58%) of protocols recommended beginning at a similar average of 17.1 ± 3.3 weeks. CONCLUSION: Similar to Bankart repair protocols, Latarjet rehabilitation protocols contain a high degree of variability with regard to exercises and motion goal recommendations. However, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols. Consequently, variability in the timing of rehabilitation goals may contribute to earlier return to play metrics identified in the broader literature for the Latarjet procedure when compared with arthroscopic Bankart repair. STRENGTH OF RECOMMENDATION TAXONOMY (SORT): Level C.


Assuntos
Artroscopia/reabilitação , Lesões de Bankart/cirurgia , Terapia por Exercício/métodos , Instabilidade Articular/cirurgia , Luxação do Ombro/cirurgia , Artroscopia/métodos , Protocolos Clínicos , Deambulação Precoce , Humanos , Força Muscular/fisiologia , Amplitude de Movimento Articular , Treinamento de Resistência , Restrição Física , Volta ao Esporte , Fatores de Tempo
7.
Int J Sports Med ; 41(3): 154-160, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31902129

RESUMO

We evaluated a range of physical characteristics related to hamstring injuries, as well as the Nordic Hamstring Exercise compliance rate, and whether this influenced the rate hamstring injury. Subjects comprised 259 male soccer players from seven high schools randomly clustered into two groups, a Nordic Hamstring Exercise group and a control group. Training and match time were logged, as well as details of hamstring injury, and subsequent time lost to hamstring injury recorded over a period of 27 weeks. The Nordic Hamstring Exercise compliance rate, injury rate per 10000 playing hours and time-lost-to-sport-injury rate were calculated. The relative risk and hamstring injury severity were also calculated. The hamstring injury rate was 1.04/10 000 h in the control group and 0.88/10 000 h in the intervention group. The relative risk for hamstring injury was 1.14. The time-lost to injury rate was 1116.3/10 000 h in the control group and 113.7/10 000 h in the intervention group; with relative risk 9.81. The Nordic Hamstring Exercise in high school soccer players significantly reduced hamstring injury severity compared to a control intervention. Our results indicate that the time-lost to injury rate should be taken into account when analyzing the severity of hamstring injury.


Assuntos
Músculos Isquiossurais/lesões , Condicionamento Físico Humano/métodos , Futebol/lesões , Adolescente , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Lesões nas Costas/epidemiologia , Lesões nas Costas/prevenção & controle , Humanos , Extremidade Inferior/lesões , Masculino , Volta ao Esporte , Fatores de Tempo , Índices de Gravidade do Trauma
8.
Curr Sports Med Rep ; 19(1): 24-28, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31913920

RESUMO

Soft tissue injuries to the head and neck are a common occurrence in sports. These anatomical regions are somewhat predisposed because of the "athletic stance" that is utilized in many close-contact sports. Although appropriate use of protective equipment, including mouth guards, helmets, and face shields, has reduced the incidence and severity of these injuries, they still occur regularly. To provide appropriate medical care, one must possess adequate knowledge of the superficial and deep anatomical structures, fundamental knowledge and skill in regard to wound care, and awareness of potential poor outcomes related to lacerations of unique structures, such as the mouth, eye, or ear.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos Craniocerebrais/diagnóstico , Traumatismos Faciais/diagnóstico , Lacerações/diagnóstico , Lesões do Pescoço/diagnóstico , Traumatismos em Atletas/terapia , Traumatismos Craniocerebrais/terapia , Traumatismos Faciais/terapia , Humanos , Lacerações/terapia , Lesões do Pescoço/terapia , Volta ao Esporte
9.
J Pediatr Orthop ; 40(2): 71-77, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31923166

RESUMO

BACKGROUND: The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports. METHODS: Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period. Retrospective review then documented patient and injury characteristics and clinical course. General linear modeling was used to analyze risk factors for prolonged return to sports, continued pain or reinjury. RESULTS: Fifty-one knees (33 in males, 65%), mean age 13.8 years (range, 5 to 17), were identified, of which 40 (78%) had MCL injuries. Over half (29, 57%) of knees had an open distal femoral physis including all 5 bony avulsion injuries. Eleven (22%) had LCL injuries of which 3 (6%) had concurrent posterolateral corner injuries. Forty-two (82%) knees had injuries that occurred during sports. Eleven knees (28%) with MCL tears had a simultaneous patellar instability episode. Knee injuries that occurred during sports had 37% shorter recovery time (P=0.02). Eight knees (16%) experienced a reinjury and 12 (24%) were followed over an extended period of time for various knee issues. Football injuries were more likely to be grade 3 (P=0.03), and football and soccer accounted for all grade III injuries. The mean return to sports was 2.2 months, with grade III cases returning at 2.4 months, and 95% of cases within 4 months. CONCLUSIONS: Isolated collateral ligament injuries are rare in adolescent athletes. MCL injuries, one-quarter of which occurred in conjunction with patellar instability events, were 4 times more common than LCL injuries, one quarter of which have other posterolateral corner structures involved. Grade III injuries represent 20% to 25% of collateral ligament injuries and occurred most commonly in football and soccer. LEVEL OF EVIDENCE: Level IV-retrospective case series.


Assuntos
Instabilidade Articular/complicações , Traumatismos do Joelho/complicações , Ligamento Colateral Médio do Joelho/lesões , Articulação Patelofemoral/lesões , Volta ao Esporte , Adolescente , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/terapia , Criança , Feminino , Humanos , Instabilidade Articular/diagnóstico por imagem , Instabilidade Articular/terapia , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/terapia , Imagem por Ressonância Magnética , Masculino , Ligamento Colateral Médio do Joelho/diagnóstico por imagem , Recidiva , Estudos Retrospectivos , Lesões dos Tecidos Moles/complicações , Lesões dos Tecidos Moles/diagnóstico por imagem , Lesões dos Tecidos Moles/terapia , Fatores de Tempo
10.
J Pediatr Orthop ; 40(2): 78-85, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31923167

RESUMO

BACKGROUND: Osteochondral autologous transplantation surgery (OATS) has been advocated for unstable osetochondritis dissecans (OCD) lesions of the adolescent capitellum, though limited information is available regarding clinical and radiographic results in North American patients. We hypothesize that single-plug OATS is safe and effective in alleviating pain and restoring function in unstable OCD. METHODS: Twenty-eight patients with unstable OCD treated with single-plug OATS were evaluated. Mean age at surgery was 14.2 years; there were 14 males. Etiology of OCD was presumed to be sports participation, including baseball (n=5) and gymnastics (n=11). Indications for surgery included unstable, deep OCD lesions; 2 lesions were uncontained, and 3 patients (11%) had OATS after failed prior surgery. OATS was performed by an anconeus muscle-splitting approach; donor grafts were harvested from the lateral femoral condyle by small arthrotomy. Functional outcomes were quantified using the Timmerman instrument. Median clinical and radiographic follow-up was 6.3 months (range, 5.0 to 27.0 mo) and 5.7 months (range, 5.0 to 26.7 mo), respectively. Furthermore, all patients returned functional questionnaires at a median of 9 months postoperatively (range, 5 to 27 mo). RESULTS: Of the 26 patients who reported preoperative tenderness, 19 (73%) patients had no tenderness at most recent clinical follow-up (P=0.02). Of 18 patients with restricted elbow motion preoperatively, 13 had achieved full range of motion (P=0.10). Both elbow flexion and extension improved significantly [flexion: median change (interquartile range)=10 degrees (0 to 10 degrees), P=0.009; extension: 0 degree (-5 to 0 degrees), P <0.001). On postoperative magnetic resonance imaging, 86% (P<0.001) of elbows had restoration of articular congruity and 93% had complete graft incorporation. Objective [median change (interquartile range)=5 degrees (0 to 15 degrees)], subjective [25 degrees (15 to 40 degrees)], and overall [35 degrees (15 to 45 degrees)] Timmerman scores improved significantly (P=0.001, <0.001, and <0.001, respectively). Of the 13 patients with >6 months follow-up, 9 patients (69%) had returned to their primary sport (P=0.27) and 100% had returned to general sports participation. There were no postoperative complications. At final follow-up, all donor knees were asymptomatic with full motion and strength. CONCLUSION: Single-plug OATS is safe and effective in improving pain and elbow function in adolescents with unstable OCD, with high return to sports rates and little donor-site morbidity. LEVEL OF EVIDENCE: Level IV-case series.


Assuntos
Traumatismos em Atletas/complicações , Transplante Ósseo , Cartilagem Articular/transplante , Articulação do Cotovelo/cirurgia , Osteocondrite Dissecante/cirurgia , Adolescente , Autoenxertos , Transplante Ósseo/métodos , Criança , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Osteocondrite Dissecante/etiologia , Amplitude de Movimento Articular , Volta ao Esporte , Transplante Autólogo , Resultado do Tratamento
13.
Int J Sports Med ; 41(5): 328-338, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31968381

RESUMO

In male handball, limited knowledge exists about the body posture and postural control in correlation to their injury occurrence and their impact on physical constitution. 91 male handball players participated and were asked about playing position and years, NSAIDs intake, sustained injuries and therapy duration. A three-dimensional back scanner and a pressure measuring plate were used. Shoulder injuries cause a differing scapular height and increase the vertebrae rotation in correlation to playing years. Lower limb injuries lead to a decrease on the Centre of Pressure (CoP) with growing game experience. Wing players show the lowest injury risk. Lower limb and shoulder girdle are mostly affected regarding the incidence of injuries. Pivot players suffer most injuries in the lower limb area (59%), whereas wing players mostly have shoulder injuries (19%). Being injured, 21% of the players continue playing, 79% pause for a minimum of six months (25%). No correlation can be determined between level of profession, use of NSAIDs and body posture or postural control. Playing position, employment situation or NSAIDs have no influence on type of injury, body posture or postural control. While shoulder injuries can be recognized in the vertebrae area, lower limb injuries can affect the CoP.


Assuntos
Traumatismos em Atletas/fisiopatologia , Equilíbrio Postural/fisiologia , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Traumatismos em Atletas/tratamento farmacológico , Humanos , Extremidade Inferior/lesões , Masculino , Equilíbrio Postural/efeitos dos fármacos , Volta ao Esporte , Lesões do Ombro/tratamento farmacológico , Lesões do Ombro/fisiopatologia , Fatores de Tempo , Adulto Jovem
14.
Br J Sports Med ; 54(2): 102-109, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31036562

RESUMO

OBJECTIVE: We compared data from the National Collegiate Athletic Association (NCAA) Concussion Study (1999-2001) and the NCAA-Department of Defense Concussion Assessment, Research and Education (CARE) Consortium (2014-2017) to examine how clinical management, return to play (RTP) and risk of repeat concussion in collegiate football players have changed over the past 15 years. METHODS: We analysed data on reported duration of symptoms, symptom-free waiting period (SFWP), RTP and occurrence of within-season repeat concussion in collegiate football players with diagnosed concussion from the NCAA Study (n=184) and CARE (n=701). RESULTS: CARE athletes had significantly longer symptom duration (CARE median=5.92 days, IQR=3.02-9.98 days; NCAA median=2.00 days, IQR=1.00-4.00 days), SFWP (CARE median=6.00 days, IQR=3.49-9.00 days; NCAA median=0.98 days, IQR=0.00-4.00 days) and RTP (CARE median=12.23 days, IQR=8.04-18.92 days; NCAA median=3.00 days, IQR=1.00-8.00 days) than NCAA Study athletes (all p<0.0001). In CARE, there was only one case of repeat concussion within 10 days of initial injury (3.7% of within-season repeat concussions), whereas 92% of repeat concussions occurred within 10 days in the NCAA Study (p<0.001). The average interval between first and repeat concussion in CARE was 56.41 days, compared with 5.59 days in the NCAA Study (M difference=50.82 days; 95% CI 38.37 to 63.27; p<0.0001). CONCLUSION: Our findings indicate that concussion in collegiate football is managed more conservatively than 15 years ago. These changes in clinical management appear to have reduced the risk of repetitive concussion during the critical period of cerebral vulnerability after sport-related concussion (SRC). These data support international guidelines recommending additional time for brain recovery before athletes RTP after SRC.


Assuntos
Concussão Encefálica/diagnóstico , Futebol Americano/lesões , Volta ao Esporte , Adolescente , Feminino , Humanos , Masculino , Recidiva , Fatores de Risco , Fatores de Tempo , Adulto Jovem
16.
J Shoulder Elbow Surg ; 29(1): 50-57, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31439428

RESUMO

HYPOTHESIS: We hypothesized that players in the National Basketball Association (NBA) who sustained a shoulder destabilizing injury could return to play (RTP) successfully at a high rate regardless of treatment type. METHODS: We used publicly available data to identify and evaluate 50 players who sustained an in-season shoulder instability event (subluxation/dislocation) while playing in the NBA. Demographic variables, return to NBA gameplay, incidence of surgery, time to RTP, recurrent instability events, and player efficiency rating (PER) were collected. Overall RTP was determined, and players were compared by type of injury and mode of treatment. RESULTS: All players (50/50) returned to game play after sustaining a shoulder instability event. In those treated nonoperatively, athletes who sustained shoulder subluxations returned after an average of 3.6 weeks, compared with 7.6 weeks in those who sustained a shoulder dislocation (P = .037). Players who underwent operative management returned after an average of 19 weeks. Athletes treated operatively were found to have a longer time interval between a recurrent instability event (70 weeks vs. 28.5 weeks, P = .001). CONCLUSION: We found 100% rate of RTP after a shoulder instability event in an NBA athlete. Players who experience shoulder dislocations were found to miss more time before RTP and were more likely to undergo surgical intervention compared with those who experienced a subluxation. Surgical repair maintained a longer interval between recurrent instability. Future investigations should aim to evaluate outcomes based on surgical procedures and identify possible risk factors predictive of recurrent instability or failure to RTP.


Assuntos
Basquetebol/lesões , Tratamento Conservador , Instabilidade Articular/cirurgia , Volta ao Esporte , Luxação do Ombro/cirurgia , Lesões do Ombro/cirurgia , Adulto , Desempenho Atlético , Humanos , Instabilidade Articular/terapia , Masculino , Recidiva , Luxação do Ombro/terapia , Lesões do Ombro/terapia , Fatores de Tempo , Adulto Jovem
17.
J Shoulder Elbow Surg ; 29(1): 121-125, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31668501

RESUMO

BACKGROUND: The economic loss following ulnar collateral ligament reconstruction (UCLR) in Major League Baseball (MLB) pitchers has not been evaluated. The purpose of this study is to quantify the financial impact of UCLR on MLB teams. We hypothesize that MLB teams incur significant losses annually as a result of salaries paid to injured players following reconstruction. METHODS: Public records were accessed to identify MLB pitchers from January 1, 2004, to December 31, 2014, who had undergone UCLR. Contract terms and time away from competition were used to approximate economic loss. Successful return was considered when a pitcher returned to play in at least 1 Minor League Baseball (MiLB) or MLB game. RESULTS: One hundred ninety-four MLB pitchers underwent UCLR from 2004 to 2014, missing on average 180.2 days of the MLB regular season. Cost of recovery (COR) amounted to $395 million, averaging $1.9 million per player. Starting pitchers accounted for the largest total COR at $239.6 million, whereas closers had the largest economic loss per player ($3.9 million/player). Only 77% of pitchers returned to MLB play. CONCLUSION: UCLR has a substantial economic impact on MLB teams. Starting pitchers represented a majority of team cost, but closers represented higher costs per pitcher.


Assuntos
Beisebol/economia , Ligamento Colateral Ulnar/lesões , Traumatismos Ocupacionais/economia , Salários e Benefícios/economia , Reconstrução do Ligamento Colateral Ulnar/economia , Adulto , Beisebol/lesões , Contratos , Custos e Análise de Custo , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/cirurgia , Ocupações/economia , Volta ao Esporte/estatística & dados numéricos , Salários e Benefícios/estatística & dados numéricos , Fatores de Tempo , Adulto Jovem
18.
J Sci Med Sport ; 23(1): 100-104, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31563440

RESUMO

OBJECTIVES: To determine whether pain perceptions and coping strategies are predictive of the following outcomes after knee surgery in athletes: (1) return to similar level of sport, (2) improvement in symptoms, and (3) improvement in kinesiophobia. DESIGN: Prospective cohort study. METHODS: 101 athletes (52 men, 49 women; mean age 32.7years) at mean 12.1months follow-up were included. Independent relationships between patient outcomes and pre-operative measures were determined: short form McGill Pain questionnaire (SF-MPQ), Pain Catastrophizing Scale (PCS), Pain Coping Measure (PCM), and the brief COPE subscales of acceptance, denial, positive reframing, and use of instrumental support. Adjustment was performed for length of follow-up, symptom duration, surgical history, age, activity level, and surgical procedure. RESULTS: Rate of return to similar level of sport was 73%; severe pain catastrophizers (PCS >36 points) had increased odds of not returning to similar level of sport (OR 11.3 CI 1.51, 236; p=0.02) whereas COPE-use of instrumental support was protective (per point increase: 0.72 CI 0.54, 0.94; p=0.02). Problem-focused coping positively correlated with improvement in IKDC-S scores (beta 0.032 SE 0.010; p=0.001). Improvement in kinesiophobia after surgery was less likely with higher pre-operative perceived pain frequency (OR 0.23 CI 0.06, 0.71; p=0.009) and higher COPE-denial scores (OR 0.43 CI 0.21, 0.88; p=0.02). CONCLUSIONS: Among athletes undergoing knee surgery, severe pain catastrophizing is negatively associated with return to similar level of sport. Instrumental support and problem-focused coping strategies are associated with improved outcomes. High preoperative pain scores are negatively associated with improvement in kinesiophobia after rehabilitation.


Assuntos
Adaptação Psicológica , Catastrofização , Articulação do Joelho/cirurgia , Percepção da Dor , Volta ao Esporte , Adolescente , Adulto , Idoso , Atletas , Feminino , Humanos , Traumatismos do Joelho/psicologia , Traumatismos do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos/psicologia , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
19.
Arthroscopy ; 36(1): 261-262, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31864587

RESUMO

Distal femoral varus osteotomy combined with meniscal allograft transplantation is a major surgical undertaking, not without risk and not to be taken on lightly by either the surgeon or the patient. It really is a salvage operation for a knee that is deteriorating and heading for arthroplasty at some future point. It is not an operation that should be offered to patients to allow them to return to sport. The fact that some patients do return to sport is good and is a credit to the operation and the patient's tenacity with rehabilitation, but we must question the rationale of such activity, which will most likely hasten the demise of the joint.


Assuntos
Meniscos Tibiais , Volta ao Esporte , Aloenxertos , Humanos , Articulação do Joelho , Osteotomia
20.
Arthroscopy ; 36(1): 274-276, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31864589

RESUMO

Hip pain is prevalent and costly, and young patients with hip femoroacetabular impingement have similar levels of pain and quality of life to older patients with hip osteoarthritis. Hip arthroscopic surgery for femoroacetabular impingement is increasing in prevalence, and the benefits of operative treatment compared with nonoperative treatment require consideration. Hip arthroscopy should not be a first-line treatment but can be necessary in cases in which high-quality, exercise-based nonsurgical treatment options have been exhausted. Patients should be informed that surgery is not necessarily cost-effective and may have an increased risk of comorbidities such as chronic pain and insomnia. Patient-reported outcomes may improve by up to 20% with either surgery or physical therapy but are not likely to return to those seen in patients without hip pain. Although most patients return to sport after hip arthroscopy, the ability to participate at a preinjury level is seen in fewer than a quarter of patients. Return-to-sport rates with physiotherapist-led nonoperative treatment are not known.


Assuntos
Impacto Femoroacetabular , Artroscopia , Articulação do Quadril , Humanos , Qualidade de Vida , Volta ao Esporte , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA